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Aim: To evaluate the changes in periodontal parameters (reduction in probing pocket depth [PPD], gain in clinical attachment level [CAL] and reduction in full-mouth bleeding on probing [BoP]) after subgingival instrumentation of periodontal pockets at different time points in systemically healthy patients suffering from periodontitis., Materials and Methods: Four databases were searched for RCTs that carried out subgingival instrumentation in periodontal pockets and evaluated PPD at a minimum of two consecutive time points other than baseline. The analysis was conducted for both all pocket depths and stratified for initially shallow (4-5 mm) and deep (≥6 mm) pockets and data were extracted for various time points, 1-2, 3-4 and 5-6 months. Weighted mean effects (WMEs) were calculated with 95% confidence interval (CI) and predictive intervals were calculated., Results: Twenty-nine RCTs were identified, and all of them were included in the meta-analysis. The results showed that for both shallow and deep pockets there was a small though clinically meaningful change between 1- to 2-month and 3- to 4-month time points and between these and 5-6 months., Conclusions: In systemically healthy patients, the greater part of reduction in PPD and gain in CAL occurs within the first 1-2 months after subgingival instrumentation. However, additional benefits in terms of pocket depth reduction occur beyond these early time points., (© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Two-dimensional semiconductors, such as transition metal dichalcogenides, have demonstrated tremendous promise for the development of highly tunable quantum devices. Realizing this potential requires low-resistance electrical contacts that perform well at low temperatures and low densities where quantum properties are relevant. Here we present a new device architecture for two-dimensional semiconductors that utilizes a charge-transfer layer to achieve large hole doping in the contact region, and implement this technique to measure the magnetotransport properties of high-purity monolayer WSe 2 . We measure a record-high hole mobility of 80,000 cm 2  V -1  s -1 and access channel carrier densities as low as 1.6 × 10 11  cm -2 , an order of magnitude lower than previously achievable. Our ability to realize transparent contact to high-mobility devices at low density enables transport measurements of correlation-driven quantum phases including the observation of a low-temperature metal-insulator transition in a density and temperature regime where Wigner crystal formation is expected and the observation of the fractional quantum Hall effect under large magnetic fields. The charge-transfer contact scheme enables the discovery and manipulation of new quantum phenomena in two-dimensional semiconductors and their heterostructures., (© 2024. The Author(s), under exclusive licence to Springer Nature Limited.)

Despite high rates of success for dental implants, implant failure due to several causes may require explantation. In the present retrospective study, implants removed between 2000 and 2022 have been registered and the cause of removal has been established. All implants were removed by a single operator (PPM) in the department of Oral Surgery of the George Eastman Dental Hospital in Rome, Italy. Characteristics of removed implants such as implant surface, morphology (bone versus tissue level implants), type of restoration (fixed versus removable), in the case of fixed restorations, mode of retention (cement versus screw-retained), location of the implant (maxillary versus mandibular arch) were recorded. Furthermore, patient-level characteristics were also recorded (systemic health conditions and medications taken, smoking habits and previous history of periodontitis). In total, 381 implants in 381 patients were removed in the 20-year time-span. The most frequent cause of removal was peri-implantitis (82.4% of implants), followed by implant malposition and loss of osteointegration. The survival time was not affected by the cause of removal, while bone level implants had a longer survival time versus tissue level implants. Maxillary implants had a higher prevalence of peri-implantitis compared to mandibular implants.

Objectives: This study aimed to describe characteristics and outcomes associated with difficult airway response team (DART) encounters in the emergency department (ED)., Methods: We performed a descriptive analysis of a prospective, single-center database of DART encounters in the ED from April 1, 2016 to March 31, 2021 cross-referenced with retrospective chart review. Adult ED patients ≥18 years old for whom a DART was activated were eligible. We prospectively collected activation characteristics, intubation indications, operator characteristics, and intubation methods used for DART encounters. Retrospective chart review was conducted to obtain patient demographics and outcome variables. Descriptive analyses were computed for all outcomes., Results: We analyzed 89 DART encounters. No intubation attempts were made prior to DART activation in 52 cases (58.4%). The most common indications for intubation were angioedema ( n  = 17, 19.1%) or other airway obstruction ( n  = 15, 16.9%). A definitive airway was established by anesthesiology ( n  = 46, 51.7%), emergency medicine ( n  = 25, 28.1%), trauma surgery ( n  = 9, 10.1%), and ENT ( n  = 5, 5.6%). The most common method of intubation used to establish a definitive airway was video laryngoscopy with a bougie or D-blade ( n  = 29, 32.6%) followed by flexible fiberoptic intubation ( n  = 19, 21.3%). A surgical airway was required in eight encounters (cricothyrotomy [ n  = 4, 4.5%]; tracheostomy [ n  = 4, 4.5%]). Cases were managed in the ED ( n  = 73, 82%), operating room (OR) ( n  = 10, 11.2%), and intensive care unit (ICU) ( n  = 1, 1.1%). All patients requiring intubation had an endotracheal or surgical airway established., Conclusion: Our findings provide important insights regarding ED DART utilization and have implications when considering institution of a DART in the ED., Competing Interests: Rosemarie Fernandez reports grant funding from the Defense Health Agency and the National Science Foundation. Nicholas G. Maldonado, Meredith Thompson, Caroline Srihari, Liam Holtzman, Jonathan Liu, Rolando Otero, and Muhammad Abdul Baker Chowdhury have no conflicts of interest to report., (© 2024 The Authors. Journal of the American College of Emergency Physicians Open published by Wiley Periodicals LLC on behalf of American College of Emergency Physicians.)

Purpose: To assess the implant failure rate and clinical and radiographic outcomes of implants affected by peri-implantitis that received surgical treatment., Materials and Methods: A systematic search was conducted of three databases (PubMed, Embase and Cochrane Library) to identify studies that examined implant failure and biological outcomes after surgical peri-implantitis treatment, including ≥ 10 patients and reporting on a follow-up period of at least 12 months. Data and risk of bias were assessed qualitatively and quantitively. Surgical modalities were subdivided into reconstructive, non-reconstructive and combined. Meta-analyses were performed for implant failure, marginal bone level and probing pocket depth at 12 and 36 months with the respective subset of available data for each time and endpoint., Results: A total of 45 studies with 3,463 treated implants were included in the quantitative evaluation. Meta-analyses revealed low implant failure rates of 1.2% (95% confidence interval 0.4%, -2.1%) and 4.2% (95% confidence interval 1.0%, -8.8%) at 12 and 36 months, respectively. No significant difference between the subgroups was observed at 12 months. At 36 months, reconstructive modalities showed a significantly lower implant failure rate (1.0%; 95% confidence interval 0.0%, 5.0%; P = 0.04, χ2(1) = 4.1) compared to non-reconstructive modalities (8.0%; 95% confidence interval 2.0%, 18.0%). The mean probing pocket depth was 3.71 mm (95% confidence interval 3.48, 3.94 mm) at 12 months and 3.63 mm (95% confidence interval 3.02, 4.24 mm) at 36 months. The mean marginal bone loss was 3.31 mm (95% confidence interval 2.89, 3.74 mm) at 12 months and 2.38 mm (95% confidence interval 1.01, 3.74 mm) at 36 months. No significant differences between the modalities were observed for bleeding on probing after either of these time points. Cumulative interventions during supportive therapy were reported in 9% of the studies., Conclusion: Surgical treatment of peri-implantitis results in a low implant failure rate in the short and medium term. No differences were noted between the different interventions with regard to failure rate. Surrogate therapeutic endpoints were improved after treatment, without significant differences between the different modalities. Therapeutic success and/or disease resolution and cumulative interventions during supportive therapy are seldom reported in the literature, but limited long-term outcomes are documented consistently.

The Notch pathway is an evolutionarily preserved signaling pathway involved in a variety of vital cell functions. Additionally, it is one of the key regulators of inflammation, and controls the differentiation and function of different cells. Moreover, it was found to be involved in skeletal development and bone remodeling process. This review provides an overview of the involvement of the Notch signaling pathway in the pathogenesis of alveolar bone resorption in different forms of pathological conditions such as apical periodontitis, periodontal disease, and peri-implantitis. In vitro and in vivo evidence have confirmed the involvement of Notch signaling in alveolar bone homeostasis. Nonetheless, Notch signaling system, along with complex network of different biomolecules are involved in pathological process of bone resorption in apical periodontitis, periodontitis, and peri-implantitis. In this regard, there is a substantial interest to control the activity of this pathway in the treatment of disorders associated with its dysregulation. This review provides knowledge on Notch signaling and outlines its functions in alveolar bone homeostasis and alveolar bone resorption. Further investigations are needed to determine whether inhibition of the Notch signaling pathways might be beneficial and safe as a novel approach in the treatment of these pathological conditions., Competing Interests: None., (© 2023 The Authors.)

Two-dimensional transition-metal dichalcogenides (TMDs) have attracted tremendous interest due to the unusual electronic and optoelectronic properties of isolated monolayers and the ability to assemble diverse monolayers into complex heterostructures. To understand the intrinsic properties of TMDs and fully realize their potential in applications and fundamental studies, high-purity materials are required. Here, we describe the synthesis of TMD crystals using a two-step flux growth method that eliminates a major potential source of contamination. Detailed characterization of TMDs grown by this two-step method reveals charged and isovalent defects with densities an order of magnitude lower than those in TMDs grown by a single-step flux technique. For WSe 2 , we show that increasing the Se/W ratio during growth reduces point defect density, with crystals grown at 100:1 ratio achieving charged and isovalent defect densities below 10 10 and 10 11 cm -2 , respectively. Initial temperature-dependent electrical transport measurements of monolayer WSe 2 yield room-temperature hole mobility above 840 cm 2 /(V s) and low-temperature disorder-limited mobility above 44,000 cm 2 /(V s). Electrical transport measurements of graphene-WSe 2 heterostructures fabricated from the two-step flux grown WSe 2 also show superior performance: higher graphene mobility, lower charged impurity density, and well-resolved integer quantum Hall states. Finally, we demonstrate that the two-step flux technique can be used to synthesize other TMDs with similar defect densities, including semiconducting 2H-MoSe 2 and 2H-MoTe 2 and semimetallic T d -WTe 2 and 1T'-MoTe 2 .

Aim: The present multi-centre randomized clinical trial with 12 months of follow-up aimed at studying the added effect of sub-marginal instrumentation before surgical treatment of peri-implantitis., Materials and Methods: Forty-two patients diagnosed with peri-implantitis were recruited. After a behavioural intervention phase including oral hygiene instructions, patients were randomized to either receiving supra- and sub-marginal instrumentation on their affected implants (control group: 21 patients and 29 implants) or only supra-marginal instrumentation (test group: 21 patients and 24 implants), before undergoing surgery. Changes in the deepest probing pocket depth (PPD) with respect to baseline and a composite outcome of treatment success (no implant loss, no bone loss > 0.5 mm, no bleeding or suppuration on probing [BoP/SoP], and PPD ≤ 5 mm) at the 12-month examination were regarded as the primary outcomes of the trial., Results: At the 12-month examination, changes in the deepest PPD with respect to baseline amounted to -2.96 mm in the control group and to -3.11 mm in the test one (MD = -0.16; SE = 0.56; p = .769), while 21.4% of the implants in the control group and 33.3% in the test group presented treatment success (OR = 1.83; SE = 1.15; p = .338). With the exception of a longer non-surgical treatment duration in the control group (differences in  = -14.29 min; SE = 2.91; p < .001), no other secondary (e.g., soft-tissue recession, keratinized mucosa height, and bone level changes, as well as BoP, SoP, profuse bleeding and implant loss rates) or exploratory (i.e., early wound healing, aesthetics, surgical and total treatment duration, surgery difficulty, intra-operative bleeding, and adverse events) outcome demonstrated statistically significant differences between groups., Conclusions: The present multi-centre randomized clinical trial did not demonstrate an added effect of performing sub-marginal instrumentation 6 weeks before the surgical treatment of peri-implantitis. Larger clinical trials are however needed to confirm the present findings (Clinicaltrials.gov: NCT03620331)., (© 2022 The Authors. Journal of Clinical Periodontology published by John Wiley & Sons Ltd.)

With new advances in infectious disease, antifouling surfaces, and environmental microbiology research comes the need to understand and control the accumulation and attachment of bacterial cells on a surface. Thus, we employ intrinsic phase-shift reflectometric interference spectroscopic measurements of silicon diffraction gratings to non-destructively observe the interactions between bacterial cells and abiotic, microstructured surfaces in a label-free and real-time manner. We conclude that the combination of specific material characteristics ( i.e. , substrate surface charge and topology) and characteristics of the bacterial cells ( i.e. , motility, cell charge, biofilm formation, and physiology) drive bacteria to adhere to a particular surface, often leading to a biofilm formation. Such knowledge can be exploited to predict antibiotic efficacy and biofilm formation, and enhance surface-based biosensor development, as well as the design of anti-biofouling strategies.

Background: The use of CGP in guiding treatment decisions in aNSCLC with acquired resistance to ALK TKIs is questionable., Methods: We prospectively assessed the impact of CGP on the decision-making process in ALK-rearranged aNSCLC patients following progression on 2 nd /3 rd -generation ALK TKIs. Physician's choice of the most recommended next-line systemic treatment (NLST) was captured before and after receival of CGP results; the percentage of cases in which the NLST recommendation has changed was assessed along with the CGP turnaround time (TAT). Patients were divided into groups: patients in whom the NLST was initiated after (group 1) and before (group 2) receival of the CGP results. Time-to-treatment discontinuation (TTD) and overall survival (OS) with NLST were compared between the groups., Results: In 20 eligible patients (median [m]age 63 years [range, 40-89], females 75%, adenocarcinoma 100%, failure of alectinib 90%, FoundationOne Liquid CDx 80%), CGP has altered NLST recommendation in 30% of cases. CGP findings were as follows: ALK mutations 30% (l1171X 10%, G1202R, L1196M, G1269A, G1202R+l1171N+E1210K 5% each), CDKN2A/B mutation/loss 10%, c-met amplification 5%. CGP mTAT was 2.9 weeks [IQR, 2.4-4.4]. mTTD was 11.3 months (95% CI, 2.1-not reached [NR]) and 5.4 months (95% CI, 2.0-NR) in groups 1 and 2, respectively (p-0.34). mOS was 13.2 months (95% CI, 2.9-NR) and 13.0 months (95% CI, 6.0-NR) in groups 1 and 2, respectively (p-0.86)., Conclusion: CGP has a significant impact on the decision-making process in ALK-rearranged aNSCLC following progression on 2 nd /3 rd -generation ALK TKIs., Competing Interests: Author TS was employed by the company Statistical Consulting Unit. Disclosure (all outside of the submitted work): AR reported personal fees from Roche, Astra Zeneca, Merck Sharpe & Dohme, Novartis, Takeda, Elli Lilly, support for attending meetings from Bristol Myers Squibb, Roche, Boehringer Ingelheim. AO reported advisory fees from Merck Sharpe & Dohme, Bristol Myers Squibb, Roche, Astra Zeneca, Novartis, Boehringer Ingelheim. Damien Urban reported personal and consulting fees from Roche, Merck Sharpe & Dohme, Takeda, Astra Zeneca, Rhenium Oncotest, Bristol Myers Squibb. MM reported consulting fees from Boehringer Ingelheim, Roche, Astra Zeneca, MSD, BMS, Abbvie, Takeda, Pomicell. AZ reported grants from Bristol Myers Squibb, personal fees from Roche, Merck Sharpe & Dohme, Bristol Myers Squibb, Astra Zeneca, Takeda. JB reported grants and personal fees from Merck Sharpe & Dohme, Bristol Myers Squibb, Astra Zeneca, Roche, Abbvie, Takeda, OncoHost, ImmuneAI, Bayer, Novartis. AA reported research funding from Bristol Myers Squibb, personal and consulting fees from Bristol Myers Squibb, Roche, Pfizer, Astra Zeneca, Takeda, Novartis. NP reported research funding from Bristol-Myers Squibb, Eli Lilly, Foundation Medicine, Gaurdant360, Merk, MSD, Novartis, NovellusDx, Pfizer, Roche, Takeda, IP: Volatile Organic Compounds For Detecting Cell Dysplasia And Genetic Alterations Associated With Lung Cancer, WO2012023138; Breath Analysis of Pulmonary Nodules, US20130150261 A1; Apparatus for treating a target site of a body, WO/2015/059646 - all outside of the submitted work. ED reported grants from Astra Zeneca, Boehringer Ingelheim, personal fees from Boehringer Ingelheim, Roche, Astra Zeneca, Pfizer, Merck Sharpe & Dohme, Bristol Myers Squibb, Novartis, Takeda, Sanofi, Merck Serono, Medison Pharma, Janssen Israel- all outside of the submitted work. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Raphael, Onn, Holtzman, Dudnik, Urban, Kian, Cohen, Moskovitz, Zer, Bar, Rabinovich, Grynberg, Oedegaard, Agbarya, Peled, Shochat and Dudnik.)

Introduction: Both pembrolizumab (P) as a monotherapy or in combination with platinum-based chemotherapy (PCT) represent standard first-line treatment options for advanced non-small cell lung cancer (aNSCLC) with PD-L1 tumor proportion score (TPS)≥50%. No predictive biomarkers exist to guide treatment decisions., Methods: 423 consecutive patients with EGFR/ALK/ROS1-wild-type PD-L1 TPS≥50% aNSCLC receiving P (n = 302) or PCT (n = 121) as a first-line treatment were identified in the electronic databases of 5 Israeli cancer centers. Overall survival (OS, months [mo]) was assessed in correlation with blood biomarkers (BB: NLR, dNLR, PLR, SII, LIPI, ALI); a predictive score was developed., Results: In the propensity score matching analysis (n = 236; 118 patients in each group matched for age, sex and ECOG PS), mOS was 17.2mo (95% CI, 13.2-36.5) and 21.3mo (95% CI, 14.8-NR) in groups P and PCT, respectively (P = .44). In group P, NLR, dNLR, PLR, LIPI, and ALI significantly correlated with OS in uni- and multivariate COX regression analyses (P < .05), whereas in group PCT, none of the BB demonstrated a significant correlation. A predictive score was developed (each parameter receiving one point): age≥65, female sex, never-smoking status, adenocarcinoma histology, dNLR≥3. In patients with predictive score 3-5, OS was significantly longer with PCT as compared to P: mOS NR (95% CI, 15.3-NR) and 8.7mo (95% CI, 5.8-13.7) (P = .0005), while OS didn't differ significantly in patients with predictive score 0-2 (P = .61)., Conclusion: With the limitations of the retrospective analysis, the proposed dNLR-based score appears to predict OS with P and PCT., (Copyright © 2021 Elsevier Inc. All rights reserved.)

The present clinical report describes athe treatment strategy for transition from of full-arch restorations supported, either partially or fully supported by failing implants that need to be removed. More specifically the staged approach proposes a deferred treatment sequence in which the failing implants or teeth are not all replaced simultaneously. On the contrary according to this technique, some failing natural or artificial abutments are preserved momentarily in order to maintain the patient with a fixed provisional restoration at all times throughout the execution of treatment, from the surgical phases until delivery of the final restoration. The present clinical report describes the staged approach in detail, compares it to other treatment options and illustrates all phases of therapy with a clinical case.

Opinion Statement: There was limited progress in the development of novel systemic approaches in the treatment of advanced malignant mesothelioma for years following the publication of the pivotal phase III trial of Vogelzang et al. that established the cisplatin/pemetrexed regimen as a standard 1st-line systemic therapy. Since then, over the last several years, a significant step forward has been made, with incorporation of immune checkpoint inhibitors and anti-angiogenic agents. In addition, better appreciation of mesothelioma biology has allowed detection of novelmolecular therapeutic targets. All the above-mentioned strategies, along with the additional promising approaches represented by adoptive T cell therapy, dendritic cell therapy, cancer vaccines, oncoviral therapy, and agents targeting mesothelin are discussed in this review. The clinical research to identify effective biologic targets and treatment combinations in malignant mesothelioma is ongoing., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Early bystander cardiopulmonary resuscitation (CPR) has been associated with better patient outcomes in cardiac arrest. Despite this, not all cases of cardiac arrest receive bystander intervention. Reasons for this gap include disparities in provision of bystander CPR between race, gender and age groups. Concern of legal liability for responders has also been described. We propose that bystanders are more likely to face litigation for lack of intervention compared to providing bystander CPR due to the presence of 'Good Samaritan' statutes in all 50 states. This review of the legal literature seeks to quantify the number of cases brought against bystanders in the US over the past 30 years and explore the reasons behind them., Methods: The Westlaw legal research database was searched for jury verdicts, settlements, and appellate opinions from all 50 states from 1989 to 2019 for personal injury or wrongful death lawsuits involving CPR. Of 506 cases manually reviewed by the authors, 170 were directly related to CPR. Case details including jurisdiction, location, date, plaintiff and defendant demographics, level of training of CPR provider, relationship to patient, motivation for the lawsuit, and case outcomes were recorded., Results: Our data show a significant difference in the number of cases of cases alleging battery versus negligence regarding provision of CPR. Of 170 cases, 167 were due to inadequate or untimely bystander CPR. Three cases alleging harm due to providing CPR were identified., Conclusions: This study represents the largest single study of legal cases involving bystander CPR in the medical literature. The likelihood of litigation is significantly higher in cases with bystander CPR absent or delayed. The authors propose the inclusion of this data and reiteration of 'Good Samaritan' statutes in all 50 states during CPR training to reassure and encourage public response to cardiac arrests., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Despite doing well on antiretroviral therapy, many people living with HIV have expressed a willingness to accept substantial risks for an HIV cure. To date, few studies have assessed the specific quantitative maximal risk that future participants might take; probed whether, according to future participants, the risk can be offset by the benefits; and examined whether taking substantial risk is a reasonable decision. In this qualitative study, we interviewed 22 people living with HIV and used standard gamble methodology to assess the maximum chance of death a person would risk for an HIV cure. We probed participants' reasoning behind their risk-taking responses. Conventional inductive content analysis was used to categorize key themes regarding decision-making. We found that some people would be willing to risk even death for an HIV cure, and some of their reasons were plausible and went far beyond the health-related utility of an HIV cure. We contend that people's expressed willingness to take substantial risk for an HIV cure should not be dismissed out of hand., (© 2019 by The Hastings Center. All rights reserved.)

Neuronal activity-inducible gene transcription correlates with rapid and transient increases in histone acetylation at promoters and enhancers of activity-regulated genes. Exactly how histone acetylation modulates transcription of these genes has remained unknown. We used single-cell in situ transcriptional analysis to show that Fos and Npas4 are transcribed in stochastic bursts in mouse neurons and that membrane depolarization increases mRNA expression by increasing burst frequency. We then expressed dCas9-p300 or dCas9-HDAC8 fusion proteins to mimic or block activity-induced histone acetylation locally at enhancers. Adding histone acetylation increased Fos transcription by prolonging burst duration and resulted in higher Fos protein levels and an elevation of resting membrane potential. Inhibiting histone acetylation reduced Fos transcription by reducing burst frequency and impaired experience-dependent Fos protein induction in the hippocampus in vivo. Thus, activity-inducible histone acetylation tunes the transcriptional dynamics of experience-regulated genes to affect selective changes in neuronal gene expression and cellular function., (Copyright © 2019 The Author(s). Published by Elsevier Inc. All rights reserved.)

The eukaryotic epigenome has an instrumental role in determining and maintaining cell identity and function. Epigenetic components such as DNA methylation, histone tail modifications, chromatin accessibility, and DNA architecture are tightly correlated with central cellular processes, while their dysregulation manifests in aberrant gene expression and disease. The ability to specifically edit the epigenome holds the promise of enhancing understanding of how epigenetic modifications function and enabling manipulation of cell phenotype for research or therapeutic purposes. Genome engineering technologies use highly specific DNA-targeting tools to precisely deposit epigenetic changes in a locus-specific manner, creating diverse epigenome editing platforms. This review summarizes these technologies and insights from recent studies, describes the complex relationship between epigenetic components and gene regulation, and highlights caveats and promises of the emerging field of epigenome editing, including applications for translational purposes, such as epigenetic therapy and regenerative medicine.

Providing incentives is an accepted and common practice in human subjects research, including clinical HIV research. While we know that financial incentives among similar studies can greatly vary, surprisingly little research exists on how to determine when such incentives are excessive or constitute an "undue inducement." Multiple factors, such as risks and benefits, study procedures, study budget, historical precedent, recommendations from institutional review boards, advice from other investigators, and local regulations may influence decisions about appropriate incentives, but little empirical data exist about what incentives are offered to potential research participants. Rules for acceptable gifts, services, and compensation should consider study location and population, but without a clearer understanding of currently offered incentives and how these practices match up to ethical beliefs of appropriateness, we continue to follow perceived trends without critical assessment. Here, we present one potential approach to explore the impact of financial incentives on biomedical HIV research and to further clarify undue inducement: the development of a framework to support ethical decision-making about payment to participate. This framework is based on input from people living with HIV, biomedical HIV researchers, ethicists, former study participants, and IRB members and includes a database that allows for tracking payment practices., (Copyright© 2018 The Hastings Center.)

Although nerve growth factor (NGF) is beneficial for the treatment of numerous neurological and non-neurological diseases, its therapeutic administration represents a significant challenge, due to the difficulty to locally deliver relevant doses in a safe and non-invasive manner. In this work, we employ degradable nanostructured porous silicon (PSi) films as carriers for NGF, allowing its continuous and prolonged release, while retaining its bioactivity. The PSi carriers exhibit high loading efficacy (up to 90%) of NGF and a continuous release, with no burst, over a period of>26days. The released NGF bioactivity is compared to that of free NGF in both PC12 cells and dissociated dorsal root ganglion (DRG) neurons. We show that the NGF has retained its bioactivity and induces neurite outgrowth and profound differentiation (of >50% for PC12 cells) throughout the period of release within a single administration. Thus, this proof-of-concept study demonstrates the immense therapeutic potential of these tunable carriers as long-term implants of NGF reservoirs and paves the way for new localized treatment strategies of neurodegenerative diseases., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Behavioral and psychological symptoms of dementia are common in nursing home residents, and the Centers for Medicare and Medicaid Services now require that nonpharmacological interventions be used as a first-line treatment. Few staff know how to implement these interventions. The purpose of this study was to pilot test an implementation strategy, Evidence Integration Triangle for Behavioral and Psychological Symptoms of Dementia (EIT-4-BPSD), which was developed to help staff integrate behavioral interventions into routine care. The EIT-4-BPSD was implemented in 2 nursing homes, and 21 residents were recruited. A research nurse facilitator worked with facility champions and a stakeholder team to implement the 4 steps of EIT-4-BPSD. There was evidence of reach to all staff; effectiveness with improvement in residents' quality of life and a decrease in agitation; adoption based on the environment, policy, and care plan changes; and implementation and plans for maintenance beyond the 6-month intervention period., (© The Author(s) 2016.)

To overcome challenges associated with optimizing function and physical activity among hospitalized older adults, we developed function-focused care for acute care (FFC-AC). The purpose of this study was to test the feasibility and preliminary effectiveness of this intervention. We hypothesized that hospitalized trauma patients exposed to FFC-AC would (1) maintain or improve function, spend more time in physical activity, and have fewer adverse events between admission and discharge; and (2) maintain or improve function, have less fear of falling, fewer depressive symptoms, less pain, be more physically resilient, and be less likely to experience adverse events at 1 month postdischarge compared with those exposed to FFC-education only (EO). FFC-AC was implemented by a research function-focused care nurse who worked on the participating units for 20 hr a week for 16 months to implement the three components of FFC-AC. The sample included 89 older orthopedic trauma patients the majority of whom were female (N = 59, 66%), white (N = 82, 92%), and not married (N = 53, 59%). At discharge and/or 30 days postdischarge, participants in the treatment site showed greater improvement in function, less fear of falling, and better physical resilience when compared with those in the FFC-EO site. Future research is needed to continue to work on engaging staff in function-focused care approaches and optimizing the hospital environment and policies to support nurses in this type of care approach.

Background: By 2050 it is anticipated that close to half (40%) of all trauma patients will be over the age of 65. Recovery for these individuals is more complicated than among younger individuals. Early mobilization has been shown to improve outcomes. Unfortunately, there are many challenges to early mobilization. The Function Focused Care Intervention was developed to overcome these challenges., Purpose: The purpose of this paper was to describe the initial recruitment of the first 25 participants and delineate the challenges and successes associated with implementation of this intervention., Results: Overall recruitment rates were consistent with other studies and the intervention was implemented as intended. Most patients were female, white and on average 79 years of age. Optimizing physical activity of patients was a low priority for the nurses with patient safety taking precedence. Patients spent most of the time in bed. Age, depression and tethering were the only factors that were associated with physical activity and functional outcomes of patients., Conclusion: Ongoing work is needed to keep patients physically active in the immediate post trauma recovery period., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Background: Risk communication involves conveying two inherently difficult concepts about the nature of risk: the underlying random distribution of outcomes and how a population-based proportion applies to an individual., Objective: The objective of this study was to test whether 4 design factors in icon arrays-animated random dispersal of risk events, avatars to represent an individual, personalization (operationalized as choosing the avatar's color), and a moving avatar-might help convey randomness and how a given risk applies to an individual, thereby better aligning risk perceptions with risk estimates., Methods: A diverse sample of 3630 adults with no previous heart disease or stroke completed an online nested factorial experiment in which they entered personal health data into a risk calculator that estimated 10-year risk of cardiovascular disease based on a robust and validated model. We randomly assigned them to view their results in 1 of 10 risk graphics that used different combinations of the 4 design factors. We measured participants' risk perceptions as our primary outcome, as well as behavioral intentions and recall of the risk estimate. We also assessed subjective numeracy, whether or not participants knew anyone who had died of cardiovascular causes, and whether or not they knew their blood pressure and cholesterol as potential moderators., Results: Animated randomness was associated with better alignment between risk estimates and risk perceptions (F1,3576=6.12, P=.01); however, it also led to lower scores on healthy lifestyle intentions (F1,3572=11.1, P<.001). Using an avatar increased risk perceptions overall (F1,3576=4.61, P=.03) and most significantly increased risk perceptions among those who did not know a particular person who had experienced the grave outcomes of cardiovascular disease (F1,3576=5.88, P=.02). Using an avatar also better aligned actual risk estimates with intentions to see a doctor (F1,3556=6.38, P=.01). No design factors had main effects on recall, but animated randomness was associated with better recall for those at lower risk and worse recall for those at higher risk (F1,3544=7.06, P=.01)., Conclusions: Animated randomness may help people better understand the random nature of risk. However, in the context of cardiovascular risk, such understanding may result in lower healthy lifestyle intentions. Therefore, whether or not to display randomness may depend on whether one's goal is to persuade or to inform. Avatars show promise for helping people grasp how population-based statistics map to an individual case.

Objective: To examine when and why women disbelieve tailored information about their risk of developing breast cancer., Methods: 690 women participated in an online program to learn about medications that can reduce the risk of breast cancer. The program presented tailored information about each woman's personal breast cancer risk. Half of women were told how their risk numbers were calculated, whereas the rest were not. Later, they were asked whether they believed that the program was personalized, and whether they believed their risk numbers. If a woman did not believe her risk numbers, she was asked to explain why., Results: Beliefs that the program was personalized were enhanced by explaining the risk calculation methods in more detail. Nonetheless, nearly 20% of women did not believe their personalized risk numbers. The most common reason for rejecting the risk estimate was a belief that it did not fully account for personal and family history., Conclusions: The benefits of tailored risk statistics may be attenuated by a tendency for people to be skeptical that these risk estimates apply to them personally., Practice Implications: Decision aids may provide risk information that is not accepted by patients, but addressing the patients' personal circumstances may lead to greater acceptance., (Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.)

Neurofibromatosis is a neurocutaneous disorder, of which two distinct entities were defined: a peripheral type I neurofibromatosis, described by Von Recklinghausen, and a central type II affecting mainly the central nervous system. Type I is characterized by neural and cutaneous manifestations, as well as skeletal, oral, and jaw expression. The purpose of the presented case is to depict radiographic manifestations of type I neurofibromatosis in the mandible. The appearance of lesions on X-ray, differential diagnosis, and treatment considerations are discussed.

A case report is presented describing the treatment of a right maxillary supernumerary incisor with dens invaginatus. Extensive caries penetration into the invagination space was subsequently followed by contamination of the included tissue, but no pulp pathosis has been detected. The purpose of this case report was to present a treatment modality that enabled the preservation of pulp vitality by a conservative endodontic approach. Clinical considerations and treatment are discussed and reported.

The differing morphological manifestations of the root canal system have been the subject of research, and the incidence of various shapes of root canal systems has been classified. The present case describes the root canal treatment of a rare morphological pattern, namely a mandibular permanent canine with three root canals. No report of a similar case has been published previously.

The presence of several canals in each root has been established as a normal morphology of the root canal system. Two case reports are presented to describe maxillary first molars with multiple canal system morphology in the palatal root. Both teeth exhibited two canals in the palatal root, although with different morphologic manifestations. One of the molars exhibited two canals in the mesiobuccal root as well.

Platelet count, prothrombin time, and activated partial thromboplastin time provide a baseline to evaluate patients with known coagulopathy, as well as present an opportunity to diagnose disease in previously symptom free patients. Current hematologic management of patients with Von Willebrand's disease uses heated Factor VIII that allows patients to undergo orthognathic surgery without significant risk of disease transmission from banked blood products.